National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Am J Alzheimers Dis Other Demen. 2020 Jan-Dec;35:1533317520951686. doi: 10.1177/1533317520951686.
Minimally invasive diagnostic biomarkers of neurodegenerative diseases such as Alzheimer's disease (AD) facilitate patient selection and cognitive progressive decline monitoring. However, the diagnostic value of circulating microRNAs (miRNAs) for early cognitive impairment and progression to dementia is currently under debate. Thus, this study aimed to assess the diagnostic performance of circulating, cerebrospinal fluid (CSF) and exosomal miRNAs in the detection of clinical cognitive impairment in mild cognitive impairment (MCI), AD, and MCI-AD.
We searched PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), VIP Chinese Science and Technology Journals Database (CQVIP), and Chinese Medicine Premier (Wanfang) to identify potentially eligible studies related to noncoding RNAs and cognitive dysfunction biomarkers published before November 2018. The quality assessment of the studies was performed according to the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist. Meta-analysis of the literature data was performed using Stata/MP 14.0 software. The corresponding effects models were selected to calculate the summary sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), and diagnostic odds ratio (DOR) and to plot the summary receiver operating characteristic curves (SROCs) and calculate the areas under the curves (AUCs).
A total of 18 studies involving 729 patients with AD, 283 patients with MCI, and 15 patients with MCI-AD were pooled. The results revealed that the sensitivity and specificity of miRNAs in the diagnosis of AD were 0.78 and 0.79, respectively, and the area under the summary receiver operating characteristic curve (AUSROC) was 0.90. The sensitivity and specificity of miRNAs in the diagnosis of MCI were 0.89 and 0.85, respectively, and the AUSROC was 0.94. The sensitivity and specificity of microRNAs in the diagnosis of MCI-AD were 0.87 and 0.84, respectively, and the AUSROC was 0.92.
Our study found that miRNAs have certain diagnostic value for cognitive impairment, with high sensitivity and specificity, especially in diagnostics with multiple miRNAs and serum-based miRNA assays.
阿尔茨海默病（AD）等神经退行性疾病的微创诊断生物标志物有助于患者选择和认知进展监测。然而，循环 microRNAs（miRNAs）对早期认知障碍和向痴呆发展的诊断价值目前仍存在争议。因此，本研究旨在评估循环、脑脊液（CSF）和外泌体 miRNAs 在检测轻度认知障碍（MCI）、AD 和 MCI-AD 临床认知障碍中的诊断性能。
我们检索了 PubMed、Embase、Web of Science、中国知网（CNKI）、维普中文科技期刊数据库（CQVIP）和万方数据知识服务平台（Wanfang），以确定与非编码 RNA 和认知功能障碍生物标志物相关的研究，这些研究发表于 2018 年 11 月之前。根据质量评估诊断准确性研究（QUADAS-2）清单对研究进行质量评估。使用 Stata/MP 14.0 软件对文献数据进行荟萃分析。选择相应的效应模型来计算汇总敏感性、特异性、阳性和阴性似然比（PLR 和 NLR）以及诊断比值比（DOR），并绘制汇总受试者工作特征曲线（SROCs）并计算曲线下面积（AUCs）。
共纳入 18 项研究，包括 729 例 AD 患者、283 例 MCI 患者和 15 例 MCI-AD 患者。结果显示，miRNAs 诊断 AD 的敏感性和特异性分别为 0.78 和 0.79，汇总受试者工作特征曲线下面积（AUSROC）为 0.90。miRNAs 诊断 MCI 的敏感性和特异性分别为 0.89 和 0.85，AUSROC 为 0.94。miRNAs 诊断 MCI-AD 的敏感性和特异性分别为 0.87 和 0.84，AUSROC 为 0.92。
本研究发现，miRNAs 对认知障碍具有一定的诊断价值，具有较高的敏感性和特异性，尤其是在使用多种 miRNAs 和基于血清的 miRNA 检测方法进行诊断时。
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